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Rural Health Information Hub

Quitline Interventions

Quitlines are toll-free telephone numbers staffed by counselors that provide or refer callers to tobacco cessation services. Quitlines are often implemented at the state level and some states offer community-based quitlines or refer callers to community resources. Quitlines are effective in increasing tobacco cessation among interested participants and recommended by the Community Preventive Services Task Force (CPSTF).

The Community Guide notes that three interventions are successful in increasing the use of quitlines:

  • Promotion through mass-reach health communications campaigns. Rural communities often promote quitlines through mass-reach tobacco cessation media campaigns. For example, the Alaska Tobacco Quitline has developed several videos that advertise their services, including messages from Quit Coaches and tobacco prevention ads that encourage users to call the quitline.
  • Provision of tobacco cessation medications, such as nicotine-replacement therapies. Several quitlines provide tobacco cessation medications at no or reduced cost to clients in rural communities. For example, the Nevada Tobacco Quitline offers free nicotine replacement therapy, including nicotine patches, gum, and lozenges, to eligible callers. 802Quits, the tobacco cessation service offered by the Vermont Department of Health Tobacco Control Program, mails free nicotine replacement therapies to eligible callers. The North American Quitline Consortium lists all the state quitlines that offer free and discounted cessation medication.
  • Referral interventions for healthcare providers and organizations. The majority of state quitlines, including Colorado, Pennsylvania, and New York, have developed fax-to-quit referral forms for providers. Many also provide e-referral services that allow providers to complete an online form. The North American Quitline Consortium has developed a map that provides a quitline profile for each state, which lists information about their provider referral programs.

Examples of Quitline Interventions

  • Several states, including Alabama, Arkansas, Colorado, Michigan, Nevada, Montana, Pennsylvania, and Wyoming, offer American Indians/Native Americans access to tailored tobacco cessation services through the American Indian Commercial Tobacco Program. This program features a quitline where callers receive tobacco cessation counseling from American Indian/Alaska Native coaches. Eligible callers can also receive free nicotine patches, gum, or lozenges.
  • North American Quitline Consortium provides information about quitlines across the United States, including quitline webpages and contact information for program coordinators.
  • Helping Alaskans Quit is a training that describes Alaska's Tobacco Quit Line. It also focuses on the brief tobacco intervention, shows provider demonstrations, and offers information about referral resources. The training shows video demonstrations of the brief tobacco intervention delivered in different types of healthcare settings by the family practice provider, substance abuse counselor, inpatient treatment provider, dentist, community health aide, and pharmacist. The training also includes information about the pharmacotherapy options available for people who use tobacco.

Considerations for Implementation

State quitlines may need to offer training on community-specific cultural factors that affect tobacco use. In addition, some state quitlines, like the Hawaii Tobacco Quitline, also promote community quitlines and cessation services for tobacco users who prefer to use a local program.

While many quitlines offer a fax-to-quit referral program, this system may pose barriers for providers who do not have sufficient time to complete paper referrals. E-referrals using electronic health records can help to address this barrier and increase the rate of referrals. For example, the Indiana Rural Health Association used a grant from the Indiana State Department of Health to implement a health information exchange technology platform in rural hospitals and clinics that enables primary care providers to refer their patients to the state's tobacco quitline. The North American Quitline Consortium offers a comprehensive guide for healthcare providers and systems that are seeking to implement e-referrals using electronic health records.

Program Clearinghouse Examples

Resources to Learn More

Guide for Implementing eReferral Using Certified EHRs
This guide provides recommendations to healthcare systems about implementing e-referrals to tobacco cessation services, especially quitlines, through electronic health records.
Organization(s): North American Quitline Consortium
Date: 9/2015

The North American Quitline Consortium
The North American Quitline Consortium (NAQC) is a crucial resource for state governments. The Centers for Disease Control and Prevention funds NAQC to provide technical assistance to state tobacco control programs in order to help improve the scope and sustainability of their quitlines.